CDM FINAL EXAM QUESTIONS
AND ANSWERS WELL
EXPLAINED
The nurse is helping a client establish goals for steps each day. After wearing a
pedometer for 2 weeks, the client knows the average number of daily steps is 2800.
What goal does the nurse encourage the client to achieve in 4 weeks?
3800
4800
5800
6800 - Answer-4800-The client should be encouraged to add 1000 steps every 2 weeks
to the daily step total. Starting with a baseline of 2800 steps, at the end of 4 weeks the
client should be attaining 4800 steps (+2000). The ultimate goal is at least 7000 steps
up to 10,000 steps for most healthy adults.
The pediatric nurse works with a group of children who are sedentary. What advice by
the nurse would most likely be successful?
Get up and walk around during ads on television
Only play video games 1 day a week
Find a time to exercise with your parents
Join a community sports team - Answer-Get up and walk around during ads on
television-For health, the 6-12 year old boy needs 12,000-16,000 steps and girls need
10,000-13,000 steps a day. TV watching is associated with obesity in children. The
nurse could make the biggest impact by encouraging kids to get more steps in during
the day by walking during advertisements during their favorite TV shows. While limiting
video games is important, children are not likely to restrict this on their own. Children,
particularly adolescents, may not want to participate in activities with their parents. For
many reasons, joining a sports team may not be possible (money, skill level, travel).
An older client asks the nurse about the benefits of Tai Chi. What response by the nurse
is best?
Improved balance
Increased leg strength
Improved cognitive function
,Increased aerobic capacity - Answer-Improved balance- Tai Chi is an Eastern mind-
body exercise practice. One of its benefits is better balance. It is not specifically
designed to increase leg strength, cognitive function, or aerobic capacity although some
participants will have improvements in this area.
The client asks the nurse how often weight training should be done each week. What
response by the nurse is best?
1-2 times per week
2-3 times per week
3-4 times per week
At least 4 times per week - Answer-2-3 times per week-The recommendation for
resistance, or weight, training is 2-3 times per week.
A client's temperature is 33° C (91.4° F). What action by the nurse is best?
Prepare to perform continuous internal temperature monitoring.
Check tympanic temperature every 30 minutes to 1 hour.
Teach the client about temporal artery temperature measurements
Delegate taking vital signs, including temperature to unlicensed personnel. - Answer-
Prepare to perform continuous internal temperature monitoring.-For hypothermia under
35° C (95° F) the nurse should prepare to use continuous temperature monitoring.
Commonly used sites include pulmonary artery catheter, bladder, rectal, distal
esophagus, and temporal artery. Tympanic temperatures are not recommended nor are
episodic readings. Temporal artery temperatures may not be as accurate this far
outside of the normal range. The unlicensed personnel can always take vital signs,
including reading the continuous temperature measurement.
A nurse has come upon the scene of a bus accident in frigid weather. The bus has gone
off a cliff and there are several people sitting or lying on the roadside. Which person
should the nurse attend to first?
Shivering
Weak, slow pulse
Red skin
Headache - Answer-Weak, slow pulse-All clients may be hypothermia, but signs of
worsening hypothermia include pale skin, muscle tightness, weakness, fatigue, slow
respiratory rate with pulmonary congestion, weak pulses, slow pulse and lowered blood
pressure. The person with the weak slow pulse has the most advance hypothermia.
A client has a core temperature of 32.2° C (90° F). Which action by the nursing student
requires the registered nurse to intervene?
Removes wet, cold clothing
Places blankets on client's head
Obtains a forced-air warming blanket
, Gives the client warm beverages - Answer-Obtains a forced-air warming blanket-A
forced-air warming blanket is appropriate for moderate hypothermia (28° C to 32.1° C
[82.4° F to 90° F]). The other actions are appropriate for this client with mild
hypothermia. Mild hypothermia is treated by allowing the client's own body to generate
heat and warm itself passively.
The nurse is caring for a client who is being actively rewarmed for moderate
hypothermia. The client's suddenly develops pulseless ventricular tachycardia. Which
action by the nurse takes priority?
Determine the rate of rewarming.
Begin immediate high-quality CPR.
Check the client's vital signs.
Increase the infusion of warmed IV solutions. - Answer-Begin immediate high-quality
CPR.-The client is pulseless, therefore the nurse must begin immediate high-quality
CPR. After the client has been resuscitated, the health care staff can determine if he or
she was rewarmed too quickly. This can lead to rapid flow of cold, hyperkalemic blood
from the extremities to the core, leading to dysrhythmias. Taking vital signs is
appropriate but not as the priority. Increasing the rate of rewarming with more warm IV
solutions may not be appropriate if the client already was rewarmed too quickly.
A client has suffered an out-of-hospital cardiac arrest. The nurse prepares to institute
therapeutic hypothermia. What action by the nurse is inconsistent with this treatment
modality?
Using two methods of temperature monitoring
Providing care with a ventilator bundle
Allowing shivering only during rewarming
Implementing pressure sore prevention methods - Answer-Allowing shivering only
during rewarming-Shivering should not be allowed during therapeutic hypothermia as is
increases metabolic rate (and oxygen consumption) and causes coagulopathies.
Sedative are used to control shivering. The other actions are appropriate.
The faculty member explains to students that which alteration is a normal age-related
change that predisposes the older client to hypothermia?
Decreased sense of thirst
Diminished balance
Decreased temperature sensitivity
Reduced metabolic rate - Answer-Decreased temperature sensitivity-An age-related
change that predisposes the older client to hypothermia is decreased sense of touch-
related sensation, making it difficult to distinguish between cool and cold. The other
changes are not related.
The nurse is planning care for a client who has severe arthritis and has very limited fine
motor hand dexterity. Which of the following would the nurse identify as the most
AND ANSWERS WELL
EXPLAINED
The nurse is helping a client establish goals for steps each day. After wearing a
pedometer for 2 weeks, the client knows the average number of daily steps is 2800.
What goal does the nurse encourage the client to achieve in 4 weeks?
3800
4800
5800
6800 - Answer-4800-The client should be encouraged to add 1000 steps every 2 weeks
to the daily step total. Starting with a baseline of 2800 steps, at the end of 4 weeks the
client should be attaining 4800 steps (+2000). The ultimate goal is at least 7000 steps
up to 10,000 steps for most healthy adults.
The pediatric nurse works with a group of children who are sedentary. What advice by
the nurse would most likely be successful?
Get up and walk around during ads on television
Only play video games 1 day a week
Find a time to exercise with your parents
Join a community sports team - Answer-Get up and walk around during ads on
television-For health, the 6-12 year old boy needs 12,000-16,000 steps and girls need
10,000-13,000 steps a day. TV watching is associated with obesity in children. The
nurse could make the biggest impact by encouraging kids to get more steps in during
the day by walking during advertisements during their favorite TV shows. While limiting
video games is important, children are not likely to restrict this on their own. Children,
particularly adolescents, may not want to participate in activities with their parents. For
many reasons, joining a sports team may not be possible (money, skill level, travel).
An older client asks the nurse about the benefits of Tai Chi. What response by the nurse
is best?
Improved balance
Increased leg strength
Improved cognitive function
,Increased aerobic capacity - Answer-Improved balance- Tai Chi is an Eastern mind-
body exercise practice. One of its benefits is better balance. It is not specifically
designed to increase leg strength, cognitive function, or aerobic capacity although some
participants will have improvements in this area.
The client asks the nurse how often weight training should be done each week. What
response by the nurse is best?
1-2 times per week
2-3 times per week
3-4 times per week
At least 4 times per week - Answer-2-3 times per week-The recommendation for
resistance, or weight, training is 2-3 times per week.
A client's temperature is 33° C (91.4° F). What action by the nurse is best?
Prepare to perform continuous internal temperature monitoring.
Check tympanic temperature every 30 minutes to 1 hour.
Teach the client about temporal artery temperature measurements
Delegate taking vital signs, including temperature to unlicensed personnel. - Answer-
Prepare to perform continuous internal temperature monitoring.-For hypothermia under
35° C (95° F) the nurse should prepare to use continuous temperature monitoring.
Commonly used sites include pulmonary artery catheter, bladder, rectal, distal
esophagus, and temporal artery. Tympanic temperatures are not recommended nor are
episodic readings. Temporal artery temperatures may not be as accurate this far
outside of the normal range. The unlicensed personnel can always take vital signs,
including reading the continuous temperature measurement.
A nurse has come upon the scene of a bus accident in frigid weather. The bus has gone
off a cliff and there are several people sitting or lying on the roadside. Which person
should the nurse attend to first?
Shivering
Weak, slow pulse
Red skin
Headache - Answer-Weak, slow pulse-All clients may be hypothermia, but signs of
worsening hypothermia include pale skin, muscle tightness, weakness, fatigue, slow
respiratory rate with pulmonary congestion, weak pulses, slow pulse and lowered blood
pressure. The person with the weak slow pulse has the most advance hypothermia.
A client has a core temperature of 32.2° C (90° F). Which action by the nursing student
requires the registered nurse to intervene?
Removes wet, cold clothing
Places blankets on client's head
Obtains a forced-air warming blanket
, Gives the client warm beverages - Answer-Obtains a forced-air warming blanket-A
forced-air warming blanket is appropriate for moderate hypothermia (28° C to 32.1° C
[82.4° F to 90° F]). The other actions are appropriate for this client with mild
hypothermia. Mild hypothermia is treated by allowing the client's own body to generate
heat and warm itself passively.
The nurse is caring for a client who is being actively rewarmed for moderate
hypothermia. The client's suddenly develops pulseless ventricular tachycardia. Which
action by the nurse takes priority?
Determine the rate of rewarming.
Begin immediate high-quality CPR.
Check the client's vital signs.
Increase the infusion of warmed IV solutions. - Answer-Begin immediate high-quality
CPR.-The client is pulseless, therefore the nurse must begin immediate high-quality
CPR. After the client has been resuscitated, the health care staff can determine if he or
she was rewarmed too quickly. This can lead to rapid flow of cold, hyperkalemic blood
from the extremities to the core, leading to dysrhythmias. Taking vital signs is
appropriate but not as the priority. Increasing the rate of rewarming with more warm IV
solutions may not be appropriate if the client already was rewarmed too quickly.
A client has suffered an out-of-hospital cardiac arrest. The nurse prepares to institute
therapeutic hypothermia. What action by the nurse is inconsistent with this treatment
modality?
Using two methods of temperature monitoring
Providing care with a ventilator bundle
Allowing shivering only during rewarming
Implementing pressure sore prevention methods - Answer-Allowing shivering only
during rewarming-Shivering should not be allowed during therapeutic hypothermia as is
increases metabolic rate (and oxygen consumption) and causes coagulopathies.
Sedative are used to control shivering. The other actions are appropriate.
The faculty member explains to students that which alteration is a normal age-related
change that predisposes the older client to hypothermia?
Decreased sense of thirst
Diminished balance
Decreased temperature sensitivity
Reduced metabolic rate - Answer-Decreased temperature sensitivity-An age-related
change that predisposes the older client to hypothermia is decreased sense of touch-
related sensation, making it difficult to distinguish between cool and cold. The other
changes are not related.
The nurse is planning care for a client who has severe arthritis and has very limited fine
motor hand dexterity. Which of the following would the nurse identify as the most
